Acute vs Chronic PDX
Good Morning
I need help to figure this one out. Patient was admitted to hospital with cellulitis of leg and treated with IV abx. After a few days and after receiving lab results back MD states due to colonization no amount of abx will help and abx is stopped after 4days. MD now documents 'chronic stasis venous ulcer and lower extremity stasis dermatitis. The treatment is wound care. Discharge diagnosis is documented as lower extremity cellulitis with underlying stasis dermatitis. The patient is in hospital for > 20 days due to challenges with placement. Pt is in and out of Skilled Nursing Facility with same problem and MD feels SNF does not give appropriate treatment to facilitate wound healing. Pt eventually dc'd to SNF after wound healed sufficiently. The PDX was coded as "Chronic venous insufficiency" I872 (DRG 300).
When I look at coding guidelines it seems as if the cellulitis could be the PDX. Pt was admitted for cellulitis and after study it was determined the abx would not be affective but now the patient had nowhere to go. Any input and advice would be great.
Thanks!
Renee, RN CCDS
I need help to figure this one out. Patient was admitted to hospital with cellulitis of leg and treated with IV abx. After a few days and after receiving lab results back MD states due to colonization no amount of abx will help and abx is stopped after 4days. MD now documents 'chronic stasis venous ulcer and lower extremity stasis dermatitis. The treatment is wound care. Discharge diagnosis is documented as lower extremity cellulitis with underlying stasis dermatitis. The patient is in hospital for > 20 days due to challenges with placement. Pt is in and out of Skilled Nursing Facility with same problem and MD feels SNF does not give appropriate treatment to facilitate wound healing. Pt eventually dc'd to SNF after wound healed sufficiently. The PDX was coded as "Chronic venous insufficiency" I872 (DRG 300).
When I look at coding guidelines it seems as if the cellulitis could be the PDX. Pt was admitted for cellulitis and after study it was determined the abx would not be affective but now the patient had nowhere to go. Any input and advice would be great.
Thanks!
Renee, RN CCDS
Comments
Thanks
Renee